{"title":"The history of warfarin.","authors":"Christine M Ball, Peter J Featherstone","doi":"10.1177/0310057X251323777","DOIUrl":"https://doi.org/10.1177/0310057X251323777","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":"53 3","pages":"148-150"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isabelle L Cooper, Anna F Pietzsch, Rosmarin Zacher, Lachlan Webb, Anita Pelecanos, Victoria A Eley
{"title":"Returning to work following parental leave: the experiences of Australian anaesthetists.","authors":"Isabelle L Cooper, Anna F Pietzsch, Rosmarin Zacher, Lachlan Webb, Anita Pelecanos, Victoria A Eley","doi":"10.1177/0310057X241265726","DOIUrl":"10.1177/0310057X241265726","url":null,"abstract":"<p><p>With increasing gender balance in specialist medical training and employment in Australia, there is a corresponding need to consider how parental leave and subsequent return to work is managed in the workplace. An electronic survey exploring the experiences of pregnancy and return to work following parental leave was distributed by the Australian and New Zealand College of Anaesthetists (ANZCA). The return-to-work component of the survey evaluated parental leave and return-to-work patterns, lactation practices and facilities, supports and resources utilised during the return-to-work process. We report on 391 return-to-work episodes from 219 respondents. One hundred and seventy-two (79%) were specialists at the time of survey completion. Six to 11 months was the most frequent duration of parental leave, and this duration was associated with higher satisfaction levels than shorter durations of leave (odds ratio 5.44, 95% confidence interval 3.18-9.31, <i>P</i> < 0.001). Breastfeeding continued in 246 (63%) return-to-work episodes, and absent or inadequate lactation facilities were reported in 239 (88%). In 227 (58%) return-to-work experiences, respondents received no formal support on returning to work. One hundred and thirty-five (62%) respondents did not utilise any existing return-to-work resources, and family and friends were the main source of support for 113 (52%) respondents. Return-to-work processes should be tailored to meet individual needs. Consistent with existing recommendations, satisfactory lactation facilities must be provided. We recommend that the period of one-to-one supervision be flexible and negotiated, to suit the unique return-to-work trajectory of each worker. Existing ANZCA resources could assist departments in supporting anaesthetists who return to work following parental leave.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"181-189"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perioperative anaphylaxis in Malaysia: A nine-year retrospective study.","authors":"Fan-Yin Kwok, Mun-Tsong Hui, Cindy Thomas Joseph, Arfah Hanim Binti Mohamad, Mohammed-Faizal Bakhtiar","doi":"10.1177/0310057X241284655","DOIUrl":"10.1177/0310057X241284655","url":null,"abstract":"<p><p>Diagnosis of perioperative anaphylaxis (POA) and identification of causative agents remain challenging. This study aimed to describe the estimated incidence, characteristics and causative agents of POA in Malaysia. This is a retrospective review of all cases of suspected POA referred to the only anaesthetic allergy centre in Malaysia from March 2014 to December 2022. One hundred and ninety patients with suspected POA of Grade 2 and above were included. Data on clinical presentation, severity, management, serum tryptase and subsequent allergy workup (including skin and serum testing results) of these patients were extracted from the database. Dynamic tryptase was elevated in half of the cases where tryptase results were available and skin tests were positive in 96% of these cases. Skin testing was positive in 113 patients (60%) overall, and more than 70% of Grades 3 and 4 anaphylaxis cases. Neuromuscular blocking agents (NMBAs) and antibiotics were the most commonly identified causative agents (27.4% and 23% respectively). The commonest NMBAs were rocuronium and atracurium, both commonly cross-reacting with cisatracurium. The overall cross-reactivity rate among NMBAs was 58%. For antibiotics, the commonest causative agents were cefuroxime, ceftriaxone and amoxicillin/clavulanic acid. Using these data, the estimated incidence of Grades 2-4 POA over this period in Malaysia was approximately 1 in 30,000 anaesthetics. However, owing to the voluntary nature of reporting, it is possible that this is an underestimate, particularly in relation to some milder Grade 2 cases which may have gone unrecognised or unreported.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"171-180"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of enhanced recovery room care models.","authors":"Guy L Ludbrook, Nick Koning, Tarik Sammour","doi":"10.1177/0310057X241275110","DOIUrl":"10.1177/0310057X241275110","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"204-206"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Awards for papers published in <i>Anaesthesia and Intensive Care</i>, 2023.","authors":"John A Loadsman, Michael G Cooper","doi":"10.1177/0310057X241298852","DOIUrl":"https://doi.org/10.1177/0310057X241298852","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":"53 3","pages":"211"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Expert opinions on the applicability of the European guidelines on postoperative delirium in Australia and New Zealand.","authors":"Neil L Pillinger, Robert D Sanders","doi":"10.1177/0310057X241300166","DOIUrl":"10.1177/0310057X241300166","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"207-210"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thanks to Reviewers.","authors":"","doi":"10.1177/0310057X251317125","DOIUrl":"https://doi.org/10.1177/0310057X251317125","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":"53 3","pages":"212"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew J Bolland, David T Andrews, Daryl L Williams
{"title":"The elective use of percutaneous transtracheal oxygen insufflation for laryngeal surgery in a patient with a known difficult airway.","authors":"Matthew J Bolland, David T Andrews, Daryl L Williams","doi":"10.1177/0310057X241285921","DOIUrl":"10.1177/0310057X241285921","url":null,"abstract":"<p><p>We report the case of successful elective percutaneous transtracheal oxygen insufflation in a patient with high-grade laryngeal stenosis, requiring repeat surgical laryngeal dilation, in the setting of multiple previous failed attempts at intubation and ventilation. This case report highlights the role of this technique as an initial management plan to provide general anaesthesia in a safe and simple way to patients with a known difficult airway. We also describe the use of an intravenous extension kit which allowed end-tidal carbon dioxide to be measured during transtracheal oxygen insufflation.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"199-203"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Survey of administration of intravenous ketamine for perioperative pain management in Australia and New Zealand.","authors":"Patryck J Lloyd-Donald, Philip J Peyton","doi":"10.1177/0310057X241309655","DOIUrl":"10.1177/0310057X241309655","url":null,"abstract":"<p><p>Ketamine is an N-methyl-d-aspartate receptor antagonist approved for use in anaesthesia, with analgesic properties. Despite publication of numerous trials and expert guidelines on its use for pain management, administration of ketamine as part of multimodal perioperative analgesia remains 'off-label'. We conducted an online, prospective survey of ANZCA Fellows, exploring current prescribing practices of intravenous ketamine for perioperative analgesia. We surveyed 2000 Fellows and received 806 responses. The factors mostly likely to influence their administration of perioperative ketamine included pre-existing chronic pain, and heavy or multiple opioid use by patients preoperatively. Amongst respondents, less senior anaesthetists and those working in public hospitals were more likely to administer intraoperative ketamine. The surgical procedures most likely to result in ketamine administration intraoperatively were open pelvic/abdominal, thoracic and major spinal surgery, where ketamine administration was likely practice for the majority of respondents, with typical loading doses that ranged widely. The commonest choices of intraoperative loading dose were between 0.2 mg kg<sup>-1</sup> and 0.6 mg kg<sup>-1</sup>. The commonest choice of intraoperative and postoperative infusion rate was in the range of 0.1-0.2 mg kg<sup>-1</sup> h<sup>-1</sup>. Postoperative ketamine infusion was most commonly prescribed as third-line or rescue analgesia. The majority of respondents thought it either 'likely' or 'very likely' ketamine would reduce postoperative chronic pain after thoracic surgery, but not in other surgical categories. Our findings suggest that off-label perioperative administration of ketamine at analgesic dose ranges is routine or common practice in major surgery for a majority of specialist anaesthetists in Australia and New Zealand.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"190-198"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adam C Cammerman, Daniel Wl Haslam, Dale A Currigan, Mark J Lennon
{"title":"A randomised trial to assess the impact of midodrine on early mobilisation after elective primary hip replacement surgery.","authors":"Adam C Cammerman, Daniel Wl Haslam, Dale A Currigan, Mark J Lennon","doi":"10.1177/0310057X241290536","DOIUrl":"10.1177/0310057X241290536","url":null,"abstract":"<p><p>Early mobilisation following elective total hip arthroplasty (THA) facilitates quicker rehabilitation, and reduces complications and hospital length of stay. Reasons for delayed mobilisation are multifactorial, but the most common cause is orthostatic intolerance. Midodrine, an oral alpha-1 agonist, is used off-label for perioperative hypotension. However, there are few randomised trials assessing its use in the perioperative setting to improve patient outcomes. The aim of the study was to determine whether midodrine improves early mobilisation following primary THA, and whether this relates to reduced orthostatic intolerance. This prospective, triple-blinded, multicentre study involved 42 patients randomised to either placebo or 20 mg midodrine, 2 h before physiotherapy, on Day 1 postoperatively. The inclusion criteria were adults undergoing elective unilateral THA under spinal anaesthesia. The primary endpoint was the ability to walk 5 m with physiotherapists. Secondary endpoints included the incidence of orthostatic intolerance and hypotension. A preplanned interim analysis showed no statistical difference in ability to mobilise 5 m (78.26% vs 78.95%, <i>P</i> = 1.0). There was no statistically significant difference in the incidence of orthostatic intolerance between the groups 17.4% vs 31.6% (<i>P</i> = 0.45). Pre-emptive use of midodrine did not improve patient mobilisation the morning after elective primary THA and had no significant effect on the incidence of orthostatic hypotension.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"151-160"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}